Validation of the Mongolian Version of the Multifactor Leadership Questionnaire (MLQ) in Clinical Leaders of Hospital

Objective: Leadership is a critical determinant of healthcare quality, workforce development, and organizational performance. The Multifactor Leadership Questionnaire (MLQ-5X), based on the Full Range Leadership Theory, is widely used to evaluate transformational, transactional, and passive-avoidant leadership styles. However, a culturally validated Mongolian version has not yet been available. This study aimed to translate, culturally adapt, and validate the MLQ-5X for clinical leaders working in hospitals across Mongolia. Methods: A cross-sectional methodological study was conducted between March and September 2022 in 11 provinces and Ulaanbaatar. The MLQ-5X was translated using WHO translation guidelines and underwent expert panel review, pilot testing, and psychometric evaluation. A total of 1,458 clinical leaders participated. Construct validity was assessed through Exploratory and Confirmatory Factor Analyses (EFA and CFtA). Reliability was measured using Cronbach’s alpha, and face validity was evaluated through participant feedback. Results: EFA supported the original nine-factor structure. CFA showed a good model fit (CFI = 0.93, TLI = 0.91, RMSEA = 0.056). Reliability was high across all subscales (α = 0.834–0.968), with overall reliability at 0.973. Face Validity Index scores indicated strong clarity (0.82) and comprehension (0.85). Conclusions: The Mongolian MLQ-5X is a valid and reliable tool for leadership assessment in healthcare settings.